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Anorexia nervosa is a form of self-starvation
leading to a weight loss of over 15 percent of one's body weight.
Anorexia is 15 to 1 more common in females and usually starts in
adolescence--14 to 16 years of age--but may occur at any age.
Complications include cessation of periods, yellowish discoloration of
palms and soles, hair loss, heart and kidney failure, and sudden death.
Bulimia nervosa is a primary disorder that gets
progressively worse without treatment. It can be accurately diagnosed
and treated. If untreated, the bulimic person will feel an increasingly
intense compulsion to binge and then purge. Abuse of laxatives and
diuretics is common in bulimia. Bulimic people often experience dramatic
swelling of the salivary glands, which leads to enlarged cheeks. Teeth
darken, and the esophagus can become irritated and in fact burst. Ulcers
are common. There may be rupture of the large or small intestine. Each
of these effects can kill you.
These disorders stem from psychological problems,
so besides being very thin, sufferers often also exhibit depression,
irritability, withdrawal, and peculiar behaviors such as compulsive
rituals, strange eating habits, and division of foods into
"good/safe" and "bad/dangerous" categories. The
majority of people who have these disorders began feeling their effects
before they got to college. Normally they begin as teenagers, though the
age range is growing, so that even girls as young as five or six are
being treated for these disorders, which is in part attributable to what
is being called second-generation anorexia, so that these youngsters are
copying their own mother's behavior. However, the loneliness and anxiety
that accompany leaving home can be a trigger for anorexia and bulimia.
In addition, if you get close to any students who are anorexic or
bulimic, the competitive challenge they offer to be thin may also lead
to your joining the ranks of those with an eating disorder, which is why
you must be careful. If you feel yourself succumbing to the pull of
either of these disorders, you must go for help.
One advantage of college is that there is usually
free counseling available, and so if you do realize that you have one of
these problems, it should not be difficult to get treatment.
Some students don't want to admit their problem to
their friends, in which case they might not want to be seen going for
counseling. If that's the case, then they should go to an off-campus
clinic rather than avoid getting help altogether. Make sure that if you
do go for help, you go to the right people, starting with a medical
doctor. While effective treatment will usually include the assistance of
a nutritionist, there are medical and psychological aspects to these
disorders that require you to see a doctor and counselor as well as a
nutritionist.
Case: Phil
Phil noted that his roommate, Geoff, ate very
little. He seemed happy enough, but Geoff was very skinny, though he'd
admitted to Phil that at one time he'd been on the heavy side. A few
times Phil brought up the subject of Geoff's eating habits, but Geoff
would get very angry when he did, so he dropped the matter because
Phil's health wasn't really his responsibility, though it did worry him.
If you notice that your roommate, or another
college friend, has an eating disorder, what should you do? Confronting
him or her on a one-to-one basis may not be effective. The person is
likely to become defensive and not admit to having an eating disorder.
Dr. Sacker recommends that you get together with a few friends and then
have a discussion with the person. If several people are telling you
that you have a problem, it's a little harder to deny it. And while it
may be tempting to ignore the problem, these disorders can be fatal, so
at the very least you should advise your RA of your concerns.
If you would like to know more about these
disorders, you could look up Dr. Sacker's Web site or one of the many
others that exist. However, while the Web can be very helpful in
providing information, it also presents a danger, as there are now chat
rooms for people who have these diseases and are looking for support in
maintaining their condition, rather than getting treatment, and where
they can learn about new ways to lose weight or vomit. If you would like
to contact Dr. Sacker directly, either for help or for a referral to a
doctor in your area, you can call him at (718) 240-6451.
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